eVisitNB commits 'serious breaches' of Official Languages Act, commissioner finds
Shirley MacLean says Department of Health has failed to ensure 3rd party provider meets linguistic obligations
New Brunswick's online health service eVisitNB has committed "serious breaches" of the Official Languages Act, and the Department of Health has failed in its duty to ensure its third-party provider meets its linguistic obligations, according to two new reports by the official languages commissioner.
Shirley MacLean investigated seven complaints, filed between October 2022 and February 2023, alleging deficiencies in French-language services on the eVisitNB platform and the Maple application provided by the private company eVisitNB Inc.
She found none of the complainants were able to receive the services they requested in French, the official language of their choice.
"One complainant, after asking twice to be served in French, ultimately decided to proceed in English. Two others, their consultation was ended … without notice. And some of them determined they had waited too long, they weren't feeling well enough to continue," said MacLean.
It's "extremely concerning," she said.
"Having service in the official language of one's choice is always important, but when we're talking about medical issues, we have to be particularly aware of the consequences that can result if that service is not available, or if in some way it's misconstrued."
She further noted several of the complainants were advised they would be unable to receive services through an English-only message: "Unfortunately, I am not able to understand your request well enough to provide treatment."
Her investigation also found problems with the quality of the French provided on the eVisitNB website and flagged an automated message that warns users who select French as language of choice that "deselecting English may increase the waiting time" and asking them if they are sure before continuing.
Francophones are receiving "a second-class service," said MacLean.
Disciplinary action can include termination
In response to the complaints that francophones received a message in English and their session was terminated, eVisitNB told MacLean's office patients cannot be transferred to another health-care provider who speaks their preferred language.
eVisitNB's policy is that health-care providers are supposed to send a message in the same language clients are attempting to access services, it said.
"The policy and process have been reviewed with all providers and disciplinary action could result from non-compliance, up to and including termination."
The Department of Health initally told MacLean's office it did not have access to the linguistic profile or other information related to the health-care professionals working for eVisitNB Inc.
It subsequently reported that eVisitNB has 26 bilingual nurse practitioners, with an average of 13 available online on any given day.
"As this does not guarantee coverage in French on every work shift, the Department of Health works with the provider to ensure compliance with the Official Languages Act," it said.
Work on 12 recommendations underway
In her reports, MacLean makes 12 recommendations to the Department of Health to rectify the situation. While a private company provides the service on behalf of the department, the department is responsible for ensuring that the third party meets its linguistic obligations, she said.
Among her recommendations are that the department take "immediate steps" to ensure all users receive services in the language of their choice, aren't prejudiced in any way by their choice of language, and that eVisitNB has adequate staffing in order to meet its obligations.
She also recommends the department report back to her office within 30 days on its progress.
In an emailed statement to CBC News, department spokesperson Sean Hatchard said the contractor has an obligation under its agreement with the department to ensure compliance with the Official Languages Act in the delivery of services.
The department has already implemented "several of the recommendations," he said, without providing any specifics.
"It will continue working with the contractor to implement the remaining recommendations and will continue to monitor progress."
Complaints continue, fix 'crucial'
Hatchard noted that when a patient books an appointment with eVisitNB, they are matched with a provider based on the language chosen in the settings of their device or eVisitNB account.
"Patients are encouraged to select their preferred language in their device settings before they log on to the eVisitNB website or app," he said. "Patients can also update their visit language preference in their eVisitNB account at any time."
MacLean contends this does not amount to equal services. "Whether you're speaking English or French, you should be able to go on the site, get the same service," she said. "You should not have to go through another step."
Her office continues to receive complaints about eVisitNB and it's "crucial" the department resolve these issues to ensure that no member of the public is at a disadvantage because of their official language of choice, she said.
In an emailed statement to CBC News, Maple said it discovered a "technical error" with its app that required users to manually change their language settings to receive care in their preferred language.
"We have worked diligently to resolve the issue, and it has already been fixed for any new registering users," Maple said.
Maple has also reached out to registered patients it believes have incorrect language settings to provide support and ensure they receive a provider matched with their language preferences, the statement said.
"We regret this technical error and apologize for any inconvenience this has caused to our patients and providers."
In the 2023-24 fiscal year, eVisitNB provided about 280,000 virtual visits to New Brunswickers, according to the Department of Health.
The service operates seven days a week, between 8 a.m. and 8 p.m., with most patients getting seen by a provider within one day, it said.
With files from Rachel Cave